Basic Information
| Provider Information | |||||||||
| NPI: | 1356826820 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | METZGER | ||||||||
| FirstName: | MAYEM | ||||||||
| MiddleName: | |||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8585 WOODWAY DR APT 234 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770632440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7632454219 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14960 PARK ROW DR | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770845165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812981144 | ||||||||
| FaxNumber: | 2812981133 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2018 | ||||||||
| LastUpdateDate: | 10/01/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-18-31996 | TX | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.